Note: Email Address must be the same with the registered email address in the Application Form to validate your request.

I          would like to withdraw my consent for the collection, use and disclosure of the personal information provided to Elburg Shipmanagement Phils., Inc. for all the purposes I had provided my consent for.

I fully understand and agree that the withdrawal of my consent to any or all purposes and depending on the nature of my request may result ESPI not being in a position to continue to provide service to me,.